Oracle releases platform for building health insurance exchanges

By Rutrell Yasin

Sep 26, 2011

Oracle has unveiled an integrated health care platform designed to help states set up health insurance exchanges.

The system consists of a broad set of the software company’s applications and technology designed to work together to provide state governments with the functionality and services needed to establish health insurance exchanges, Oracle officials said.

Health care reform legislation signed into law by President Barack Obama last year requires states to create, by 2014, online marketplaces for uninsured and underinsured consumers to purchase affordable health care coverage. The legislation also requires states to build health information exchanges for the transfer of health care information electronically across organizations with a region, community or hospital.

Both exchanges will require IT departments to forge interoperability, data analysis, privacy and security into the exchanges.

Establishing a sustainable health insurance exchange presents serious challenges to state governments, such as enabling residents and small businesses to determine eligibility for subsidies, Oracle officials said.

The exchanges must present plans from providers that best match peoples’ needs and family situation, enable enrollment and premium payments, and ensure that people and employers are able to better manage major life events.

State governments must transform legacy IT systems into enterprisewide platforms that can support multiple programs, be deployed more rapidly and cost-effectively, and deliver a comprehensive view of the services provided to people and their families, Oracle officials said.

The applications can support Health and Human Services Department programs and core business functions such as eligibility and enrollment; billings, collections and premium reconciliation; customer service; premium tax credit tracking; broker management; payment processing and financial and management reporting.

Oracle is not the only major software company seeking to meet the health reform needs of state governments.

In February, Microsoft unveiled turnkey technology products to help states deploy health insurance exchanges. The company introduced the Microsoft State Health Insurance Exchange, which includes core technology components from Microsoft and its partners. Microsoft's offering provides an interoperable framework that connects new and existing government and private insurer systems.